Provider Demographics
NPI:1740759232
Name:KING NURSING LLC
Entity Type:Organization
Organization Name:KING NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:773-491-8323
Mailing Address - Street 1:4316 W ADAMS ST APT 2E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60624-2641
Mailing Address - Country:US
Mailing Address - Phone:773-491-8323
Mailing Address - Fax:
Practice Address - Street 1:4316 W ADAMS ST APT 2E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-2641
Practice Address - Country:US
Practice Address - Phone:773-491-8323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No174200000XOther Service ProvidersMeals
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care